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Case study for restraints
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The purpose of this paper was to understand what the best practice was for the utilization and application of restraints in the cognitively impaired. For this paper’s purpose, “cognitively impaired” will be defined as “altered cognitive function”, either temporary or permanent (Craven, 2013, p. 1214). The use and surrounding knowledge of restraints has undergone critical changes that affect nurses’ care plans and the patients’ therapeutic outcomes. According to the Joint Commission, all licensed healthcare professionals are to adhere to the guideline “that require restraints to be a part of the medical treatment after all less other appropriate disciplines have been consulted, and supporting documentation for their use has been provided” (Craven et. al, 2013, p. 584). This means that nurses must provide optional methods to defer the use of restraints, but if it is not possible, they must receive providers’ orders and approval for application.
The significance of the correct utilization and application of restraints is upheld by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) stating that physical restraints are applied only after other methods and options have proved unsuccessful in controlling disruptive behaviors (Smith et, al, 2003, p. 27). JCAHO and the Center for Medicare and Medicaid Services (CMS) have strict focus on patient rights as studies have shown that restraints can cause more harm than good. The definition of restraints is any physical method of reducing normal ability or freedom of movement, activity, or access of the patients’ body (Craven et. al, 2013, p. 584).
The present barriers to applying this evidence-based practice are due primarily to deficient knowledge. Although JCAHO and CMS ...
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...th patients, and data collection through accurate documentation.
References
Craven, R. F., Hirnle, C. J., & Jensen, S. (2013). Fundamentals of nursing: Human health and function (7th ed.). Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins.
Delaney, K. R. (2006). Evidence base for practice: Reduction of restraint and seclusion use during child and adolescent psychiatric inpatient treatment. Worldviews on Evidence-Based Nursing, 3(1), 19-30.
Hamers, J., Gulpers, M., & Strik, W. (2004). Use of physical restraints with cognitively impaired nursing home residents.Journal of Advanced Nursing, 45(3), 246-251.
Smith, N. H., Timms, J., Parker, V. G., Reimels, E. M., & Hamlin, A. (2003, January). The impact of education on the use of physical restraints in the acute care setting. The Journal of Continuing Education in Nursing, 34(1), 26-33.
A restraint is any physical or chemical measure in the healthcare setting to keep a patient from being free to move (Craven, Hirnle & Jensen, 2013). Nurses are presented with dilemmas in deciding whether to use restraints to protect the patient from falls, harming themselves or others, suppress agitation and to facilitate treatment. Improper usage and misconceptions of restraining can have negative consequences including physical and psychological issues. Physical and psychological disadvantages
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